Bizarre Night

To call this night’s admissions bizarre is probably an understatement. The patients who came in after office hours today all have symptoms worthy of 3 episodes of HOUSE. I have no answers to any of them.

Consider these:

1. A 16 year old boy with abnormal behaviour for an entire month (yeah, and the parents had to bring him tonight!). On examination, he is all stiff, and I mean really stiff, from head to toe! He has these pair of stary eyes that looked as if he is staring past you at some invisible fella behind you! Real eerie.

2. A 20+ lady who also came in with abnormal behaviour. When I saw her, she was sitting up in her bed, with eyes closed and the lids were blinking at about 100 blinks per minute. Apparently she had the same symptoms a few months back and was ‘cured’ by a bomoh. Now the hubby thinks the same evil spirit has come back to haunt her.

3. An elderly man who presented with abnormal movements of his limbs. His limbs would sway and move in a dance-like motion. We call this choreoathetosis. Again, I have no idea what he has, we are still investigating. Ironically, the man who passed away whom I blogged about earlier also had similar movements! I wonder if they are related.

4. Another man who is HIV+ started convulsing in the ward. I have a feeling I might lose this one.

The last one is easy though, which ligthened an otherwise very depressing night round.

A 19 year old girl swallowed 100 ml of ‘Sunsilk’ shampoo (she said it’s the pink one) in an attempt to give her gastrointestinal tract a good aromatic wash kill herself.

Why? Because she had ’stress’ (a.k.a boy friend problem).

Fri, 051007 @ 2141

Update:

Patient No 1: CT scan done but till press time, no idea what are the findings.

Patient No 2: She was perfectly well this morning and so the CT scan of the brain was cancelled. It would appear that the ‘evil spirits’ have left her at dawn!

Patient No 3: His CT brain was normal but he is still ‘dancing’ away.

Patient No 4: I have no news about this patient.

Patient No 5: Discharged, I hope she changes her shampoo brand and not drink it.

Sat, 061007 @ 2031; so zonked after the call I slept the day away.

Honesty

We fouled up, and a patient passed away.

I felt a shiver when some fellow specialists asked me about a particular patient in my ward as we all sat down for a cuppa yesterday before starting the day’s work.

That patient was admitted the day before yesterday and was seen by the on-call team. When I saw him in the morning along with my team, we disagreed with some of the management and made the necessary changes. Just before I moved on to another patient, this patient’s apparently elevated potassium level was highlighted to me by the MO.

My orders were to repeat the ECG (the first ECG was not recent and not indicative) and the renal profile stat and that they should be reviewed immediately and action taken. I also ordered measures be taken to bring down the level.

And that was that. I didn’t see the patient again until I heard the bad news the next morning. Apparently the patient passed away sometime in the night and the on-call team believed the cause of death could have been the high potassium level, or at least it played a major role in the patient’s demise.

Later on as I walked into my ward, the MO-in-charge of that patient’s face was decidedly ashen and she had fear and distress in her eyes. She quickly explained that she had ‘forgotten’ to review the ECG and check on the patient. She said she was very tired after a particularly bad on-call the day before and couldn’t think straight. The HO beside the MO hastily made a similar confession.

Now both of them fear “being singled out in the mortality meeting and blamed”.

She asked me this: “What excuse should I give? How will I answer if they ask me to explain myself?”

I answered her “None, just tell the truth, be honest about it. We are not perfect. We will admit our mistakes, learn from it and promise not to repeat it.”

That, in my opinion, is the best thing to do. Mistakes cannot be undone but it can be a tool for learning. There is no need to cover up.

Today, the MO was a lot more cheerful. Apparently the repeat renal profile, though still showing a raised potassium level, was a ‘grossly hemolysed’ specimen rendering the level inaccurate. Another repeat showed a normal potassium level. The repeat ECG was not suggestive of raised potassium level.

Whatever it was, I hope the lesson has been learnt.

Duit Raya

Just when I was getting disenchanted about working and life as a whole, Life throws you an unexpected surprise in the form of some duit raya (spending money for the coming festivity). I received these 2 days ago. The Company unexpectedly announced that ALL (regardless of race) will receive some duit raya)!

It was a pleasant surprise indeed.

Anyway most of it are already spent. RM 50 for a friend who just got married. I bought another pair of swimming trunks (my 5th!) with part of it and the wife got some stuff she needed.

I think the Company is finally beginning to have a soul again.

Fri, 051007 @ 1408; neck still hurts bad. Sigh.

True Success

I would like to share one of my favourite poem with you:

How do you measure success?

To laugh often and much;

To win the respect of intelligent people

and the affection of children;

To earn the appreciation of honest critics

and endure the betrayal of false friends;

To appreciate beauty;

To find the best in others;

To leave the world a bit better

whether by a healthy child,

a redeemed social condition,

or a job well done;

To know even one other life has breathed

because you lived -

this is to have succeeded.

Ralph Waldo Emerson

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Hope you were inspired as much as I was by it.

Fri, 051007 @ 0745; on-call and I had to sprain my neck. Can’t turn my head right or left. Talk about being focused.